Conditions &
Treatments - Osteochondritis Dissecans
of the Knee

Osteochondritis Dissecans (OCD) is a
condition which involves the subchondral bone becoming avascular
resulting in the lesion of articular cartilage and its adjacent
underlying subchondral bone from the articular surface of a
joint (1, 2, 3). The etiology of OCD is idiopathic and not
completely understood (2, 3). Some suggested etiological factors
include: trauma (chronic or repetitive), deficient blood supply,
endocrinopathies, and genetic factors (2, 3). This condition can
occur at multiple joints but the femoral condyles at the knees
account for 75% of the lesions with the medial condyle being
more commonly affected versus the lateral femoral condyle or
inferior surface of the patella (2, 3) OCD is most commonly
found in individuals who are in the pre/early teens to early
twenties (10-21 years of age) (2, 3).

Symptoms of Osteochondritis Dissecans (OCD) of the Knee
The severity and stability of the lesion at the knee will
present with varying degrees of symptoms for the patient (2, 3).
Individuals who present with OCD usually present with vague
poorly localized pain around the condyle and swelling at the
knee which can be accompanied by insidious onset of clicking,
popping, catching, giving way and locking (2, 3, 4).

PT Findings in Patients’ with Osteochondritis Dissecans
of the Knee
Individuals
with OCD of the knee may present with atrophy of the thigh
secondary to relative disuse and ambulate with the affected
extremity externally rotated to relieve pressure on the lesion
(3). A special test, known as the Wilson Test, can be performed
by the therapist to evaluate for medial OCD lesions (3, 5).
"This test is performed by having the therapist hold the
patient's foot in internal rotation with the knee flexed at 90
degrees. The patient then extends his or her leg against
resistance. The test is considered positive when the patient
feels pain at approximately 30degrees of flexion. The discomfort
is believed to result from impingement of the tibial spine
against the lesion. Pain usually is relieved when the leg is
allowed to come out if internal rotation (3, 5)." Other medical
tests such a radiograph (tunnel view) and MRI could be performed
to to confirm OCD or determine any other pathology (3, 4).

Treatment Options for Osteochondritis Dissecans of the Knee
In cases where the OCD lesion at the knee is stable,
conservative treatment such as physical therapy may be
recommended to allow for spontaneous healing and to assist with
any deficits which may include ROM, strength, gait, function,
posture and pain management. If conservative methods are
unsuccessful surgical methods such as: arthroscopic lavage or
debridement, radiofrequency energy, bone drilling, osteochondral
autografts or allografts, internal fixation of bone fragments,
and autologous chondrocyte implantation may be performed (2, 3).

Please review our terms and conditions
carefully before utilization of the Site. The information on this Site is for
informational purposes only and should in no way replace a conventional visit to
an actual live physical therapist or other healthcare professional. It is
recommended that you seek professional and medical advise from your physical
therapist or physician prior to any form of self treatment.